2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 FOREWORD I welcome the publication of the 2015 Qatar National

QATAR NATIONAL CANCER REGISTRY QNCRANNUAL REPORT2015

2015

QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015

2015 QATAR NATIONAL CANCER REGISTRY QNCR

2015 Cancer Annual ReportState of Qatar

National Cancer ProgramQatar National Cancer Registry Ministry of Public Health, Qatar P.O. Box 42 Doha, [email protected] www.nhsq.info Printed in Qatar, 2017.

Citation: Qatar National Cancer Registry, Ministry of Public Health, Qatar Cancer Incidence Report, 2015.Doha: 2017.

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QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015

CONTENTSDISCLAIMER

Abbreviations........................................................................................................................................................7

Foreword ..............................................................................................................................................................9

QNCR: Qatar National Cancer Registry ................................................................................................................10

Data Management ................................................................................................................................................11

Material and Methods ...........................................................................................................................................12

Overall Cancer Incidence ......................................................................................................................................16

Cancer Incidence amongst Qataris .......................................................................................................................24

Cancer Incidence amongst Non-Qataris ................................................................................................................28

Comparaison with the year 2014 ..........................................................................................................................32

Comparaison with Non-Qataris .............................................................................................................................34

International Perspective ......................................................................................................................................35

Pediatric Cancer Incidence ....................................................................................................................................38

Cancer Mortality ...................................................................................................................................................42

All Cancers C00-C96 .............................................................................................................................................46

C50 Breast ............................................................................................................................................................47

C18-C21 Colorectal ...............................................................................................................................................49

C61 Prostate .........................................................................................................................................................51

C82-C85, C96 Non-Hodgkin Lymphoma ...............................................................................................................52

C91-C95 Leukemia ................................................................................................................................................54

C73 Thyroid gland ................................................................................................................................................55

C33-C34 Trachea, bronchus and lung ....................................................................................................................56

C44 Non-Melanoma skin cancer ............................................................................................................................58

C22 Liver and intrahepatic bile ducts ...................................................................................................................59

C70-C72 Brain & CNS ...........................................................................................................................................60

Acknowledgement ................................................................................................................................................89

References ............................................................................................................................................................90

Information included in this report reflects the data at the time of closing the database for cleaning and analysis on August 2016. QNCR continues to receive more data and updates, so any missing or incomplete information, will be completed later on, and can be provided upon specific requests through an email to [email protected]

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Figure 1: Databases structure at the QNCR ...............................................................................................................................10

Figure 2 : Schematic structure at the QNCR ..............................................................................................................................10

Figure 3: Malignant cancer incidence distribution by nationality ............................................................................................20

Figure 4: Malignant cancer incidence distribution by gender ..................................................................................................20

Figure 5: Age Standardized Incidence Rate ASIR for all malignant cancers ...........................................................................21

Figure 6: Cancer incidence by gender among Qataris .............................................................................................................24

Figure 7: Cancer incidence by gender among Non-Qataris ....................................................................................................28

Figure 8: Number of most common new cancer cases compared to the year 2014 ..............................................................32

Figure 9: Number of most common new cancer cases compared to the year 2014, among Qataris ...................................32

Figure 10: ASIR Distribution compared to 2014 .........................................................................................................................33

Figure 11: ASIR Distribution among Qataris compared to 2014 ..............................................................................................33

Figure 12: Number of most common new cancer cases during 2015 among Qataris compared to Non-Qataris ..............34

Figure 13: ASIR Distribution comparaison across populations - Qatar 2015 ...........................................................................34

Figure 14: Crude rate of incidence in Qatar 2015 compared to regional countries ...............................................................35

Figure 15: cumulative risk of incidence in Qatar 2015 compared to regional countries ........................................................35

Figure 16: ASR in Qatar 2015 compared to regional countries ................................................................................................35

Figure 17: Pediatric cancer incidence distribution by nationality .............................................................................................38

Figure 18: Pediatric cancer incidence distribution by gender ..................................................................................................38

Figure 19: cTNM group staging for female malignant breast cancer ......................................................................................48

Figure 20: cTNM distribution for malignant colorectal cancer .................................................................................................50

Figure 21: cTNM Distribution for malignant prostate cancer ...................................................................................................51

Figure 22: cTNM Distribution for non-Hodgkin Lymphoma .....................................................................................................53

Figure 23: cTNM Distribution for malignant thyroid cancer .....................................................................................................55

Figure 24: cTNM Distribution for malignant lung cancer ..........................................................................................................57

TABLE OF FIGURES LIST OF TABLES

Table 1: Distribution of reported records from different healthcare providers .......................................................................11

Table 2: WHO Standard Population ............................................................................................................................................13

Table 3: Basic Distribution of cancers by nationality and gender.............................................................................................16

Table 4: Comprehensive table of most common malignant cancers across all nationalities and genders ..........................17

Table 5: Most common malignant cancer among males of all nationalities ...........................................................................18

Table 6: Most common malignant cancer among females of all nationalities ........................................................................19

Table 7: Most common cancers across all genders of Qataris, 2015 .......................................................................................24

Table 8: Most common cancers among male Qataris ...............................................................................................................25

Table 9: Most common cancers among female Qataris ............................................................................................................25

Table 10: Most common cancers across all genders of Non-Qataris .......................................................................................28

Table 11: Most common cancers among male Non-Qataris ....................................................................................................29

Table 12: Most common cancers among female Non-Qataris .................................................................................................29

Table 13: Most common cancers among pediatrics ..................................................................................................................39

Table 14: Most common cancer deaths among Qataris ...........................................................................................................42

Table 15: Basis of diagnosis of malignant cancers .....................................................................................................................46

Table 16: ICDO-3 Histology distribution of female malignant breast cancer ..........................................................................47

Table 17: Treatment types for female malignant breast cancer ................................................................................................48

Table 18: Histology distribution for malignant colorectal cancer .............................................................................................49

Table 19: Treatment types for malignant colorectal cancer ......................................................................................................50

Table 20: Histology distribution for malignant prostate cancer ...............................................................................................51

Table 21: Treatment types for malignant prostate cancer .........................................................................................................51

Table 22: Histology distribution for non-Hodgkin Lymphoma .................................................................................................52

Table 23: Treatment types for non-Hodgkin Lymphoma ...........................................................................................................53

Table 24: Histology distribution for leukemia.............................................................................................................................54

Table 25 : Histology distribution for malignant thyroid cancer .................................................................................................55

Table 26: Histology distribution for malignant lung cancer ......................................................................................................56

Table 27: Treatment types for malignant lung cancer ...............................................................................................................57

Table 28: Histology distribution for non-melanoma skin cancer ..............................................................................................58

Table 29: Histology distribution for malignant liver cancer .......................................................................................................59

Table 30: Histology distribution for malignant brain cancer .....................................................................................................60

Table 31: Treatment types for malignant brain cancer ..............................................................................................................61

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LIST OF APPENDICES

Appendice 1: Fact sheet on all cancers in Qatar during 2015 ..................................................................................................64

Appendice 2: Malignant cases distributed by gender and nationality ....................................................................................65

Appendice 3: In situ cases distribution by gender and nationality ..........................................................................................68

Appendice 4: Malignant cases distribution by age groups across all nationalities ................................................................69

Appendice 5: Malignant cases distribution by age groups among Qataris ............................................................................75

Appendice 6: Malignant cases distribution by age groups among Non-Qataris ...................................................................78

Appendice 7: Pediatric cases by age groups .............................................................................................................................83

Appendice 8: Data notification form ..........................................................................................................................................84

ABBREVIATIONS

ASR Age Standardized RateASIR Age-Specific Incidence RatecTNM Clinical Tumor Node Metastases stageCTR Certified Tumor RegistrarCNS Central Nervous SystemEMRO Eastern Mediterranean Regional Office (World Health Organization)GI Gastro-IntestinalHMC Hamad Medical CorporationICD 10 International Classification of Disease 10th RevisionICD O-3 International Classification of Disease for Oncology 3rd RevisionMDT Multi-Disciplinary TeamMTA Medical Treatment AbroadNCCCR National Center for Cancer Care and ResearchNCP National Cancer ProgramNCS National Cancer StrategyNHS National Health StrategyPHCC Primary Healthcare CorporationQNCR Qatar National Cancer RegistryMoPH Ministry of Public Health

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FOREWORD

I welcome the publication of the 2015 Qatar National Cancer Registry. This is an important achievement. Population-based cancer registries provide quality data to ascertain the cancer incidence, prevalence and survival in a population. They are important as they allow policy makers and service planners to measure the magnitude of the problem as well as the effectiveness of public health initiatives such as screening for selected cancers. They also, enable the evaluation of our cancer services providing diagnosis and treatment. Finally, they allow for international comparisons and are essential for world-class cancer research.

This document will be an invaluable tool for those concerned with the burden of cancer in the State of Qatar, and presents an excellent opportunity for understanding the response of our health system to the challenge posed by cancer thus providing a basis for improvement and change. Indeed Qatar is now entering a new stage in the development of cancer services aiming at a more efficient and effective prevention, diagnosis, treatment and rehabilitation towards the goals set by our National Health Strategy 2017-2022 within the framework of the National Vision 2030.

H.E. Dr. Hanan Al KuwariMinister of Public Health

Let me use this opportunity to thank the individuals and institutions who made this undertaking possible. First of all the Hamad Medical Corporation (HMC), which set the foundation of the cancer registry, and all other stakeholders such as the National Center for Cancer Care & Research (NCCCR), and the members of the Advisory Committee for the continuous engagement, support and scientific input.

I would like to confirm my appreciation to the team of Qatar National Cancer Registry at the Ministry and the complete team members of the National Cancer Program

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INTRODUCTION

Since its creation on January 2014, the QNCR, operating under the National Cancer Program in the Ministry of Public Health, is systematically collecting cancer information from all healthcare providers and sectors, through the home-made online application.

The historical data that used to be collected by the former Qatar Cancer Registry at HMC has entirely moved to the new database at QNCR and is made available to the home-based registry at NCCCR. This data went through a rigorous and complete data cleaning process, and has allowed the update of the information previously published in the cancer incidence annual report on 2014.

CURRENT STRUCTURE

QNCR has largely developed since its creation at MoPH in 2014. In addition to the cancer incidence database, QNCR is now managing two more others. The current structure in terms of data looks as follows:

Figure 1: Databases structure at the QNCR

All three databases are interconnected based on the unique identifier of the Qatari ID, allowing tracking of patient across the three of them.

Figure 2 : Schematic structure at the QNCR

ADVISORY COMMITTEE

The Advisory Committee to the QNCR held two meeting during the year 2015, during which the following actions were taken:

• Update the data notification form• Update data items collected, through name

modifications, to deleting certain data items.• Discuss the mortality and cause of death related

to cancer

The committee had also the chance to discuss multiple other issues related to cancer screening data. In addition to that, the committee members participated in reviewing and commenting on this report.More information and details about this committee can be read at the Qatar Cancer Incidence Report of 2014.

QNCR: QATAR NATIONAL CANCER REGISTRY

CANCER INCIDENCEDATABASE

CANCER SCREENING DATABASE

CANCER WAITING

TIMES DATABASE

DATA PROVIDED THROUGH THE

ONLINE APPLICATION

DATA ABOUT CANCER PATIENTS

DATA PROVIDED BY PHCC THROUGH A

SECURED FTP CHANNEL

DATA ABOUT HEALTHY INDIVIDUALS

UNDERGOING CANCER SCREENING

DATA PROVIDED BY THE QUALITY

DEPARTMENT AT MOPH

DATA ABOUT SUSPECTED CANCER

CASES

SCREENING

INCIDENCE QIDQID

QID

WAITING

DATA MANAGEMENT

DENOMINATOR

Cancer incidence nominator covers all cases diagnosed with cancer in the State of Qatar regardless of the visa status or the nationality, in addition to Qatari cases diagnosed abroad, based on the whole population of Qatar during the same year, 2015

Whilst for the calculation of prevalence and survival, we considered the Qatari population only, for being a stable population, which allows a reasonable control on the information compared to Non-Qatari population.

REPORTED RECORDS

Among all records reported to QNCR, this year, representing cases diagnosed with different cancers of different behaviors from different healthcare providers, there were cases reported by multiple sources. Before the case consolidation process, the following table summarizes the distribution of reported records:

Table 1: Distribution of reported records from different healthcare providers

Source % of overall reported records

HMC 71.3%

Death Notification 16.2%

MTA 2.1%

Pediatrics 2.8%

Al Ahli Hospital 4.0%

Al Borg Laboratories 2.5%

Al Emadi Hospital 0.8%

Doha Clinic 0.2%

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MATERIAL AND METHODS

DEFINITIONS

Incidence3

Incidence is the number of new cases arising in a given period in a specified mid-year population. This information is collected routinely by cancer registries. It can be expressed as an absolute number of cases per year or as a rate per 100,000 persons per year (see Crude rate and ASR below).

Mortality3

Mortality is the number of deaths occurring in a given period in a specified population. It can be expressed as an absolute number of deaths per year or as a rate per 100,000 persons per year.

Prevalence3

The prevalence of a particular cancer can be defined as the number of persons in a defined population who have been diagnosed with that type of cancer, and who are still alive at the end of a given year. Complete prevalence represents the number of persons alive at certain point in time who previously had a diagnosis of the disease, regardless of how long ago the diagnosis was, or if the patient is still under treatment or is considered cured. Partial prevalence , which limits the number of patients to those diagnosed during a fixed time in the past, is a particularly useful measure of cancer burden.

Prevalence is presented for the adult population only (ages 15 and over), and is available both as numbers and as proportions per 100,000 persons.

Crude Rate3

Data on incidence or mortality are often presented as rates. For a specific tumor and population, a crude rate is calculated simply by dividing the number of new cancers or cancer deaths observed during a given time period by the corresponding number of person years in the population at risk. For cancer, the result is usually expressed as an annual rate per 100,000 persons at risk.

Age Standardized Rate ASR3

An age-standardized rate (ASR) is a summary measure of the rate that a population would have if it had a standard age structure. Standardization is necessary when comparing several populations that differ with respect to age because age has a powerful influence on the risk of cancer. The ASR is a weighted mean of the age-specific rates; the weights are taken from population distribution of the standard population. The most frequently used standard population is the World Standard Population. The calculated incidence or mortality rate is then called age-standardized incidence or mortality rate (world). It is also expressed per 100,000.

Cumulative Risk3

Cumulative incidence/mortality is the probability or risk of individuals getting/dying from the disease during a specified period. For cancer, it is expressed as the number of new born children (out of 100) who would be expected to develop/die from a particular cancer before the age of 75 if they had the rates of cancer observed in the period in the absence of competing causes.

EQUATIONS

Crude Incidence Rate1

It is then calculated according to the following equation:

Crude Incidence Rate =

Total Number of cancer cases diagnosed in the given year

×100000Total Population in the same

year

Age-Specific Incidence Rate ASIR 4

The Age-Specific Incidence Rate ASIR is calculated simply by dividing the number of cancer incidences observed in a given age category during a given time period by the corresponding number of person years in the population at risk in the same age category and time period. For cancer, the result is usually expressed as an annual rate per 100,000 person-years.

ASIR =

Number of cancer cases diagnosed in the given age group

×100000Population at risk

in the same age group

Age Standardized Rate ASR 4

It is calculated as ASR = ∑ ASIR ×Weight of Standard Population

Whereby the weight of standard population is calculated as follows

Weight =Standard population of a given age group

Total standard population

Table 1 represents the standard age-group population published by WHO.5

Table 2: WHO Standard Population

Age Group Population Weight

0-4 88,569 0.088569

5 - 9 86,870 0.0868696

10 - 14 85,970 0.0859699

15 - 19 84,670 0.0846704

20 - 24 82,171 0.0821712

25 - 29 79,272 0.0792723

30 - 34 76,073 0.0760734

35 - 39 71,475 0.071475

40 - 44 65,877 0.0658769

45 - 49 60,379 0.0603789

50 - 54 53,681 0.0536812

55 - 59 45,484 0.0454841

60 - 64 37,187 0.037187

65 - 69 29,590 0.0295896

70 - 74 22,092 0.0220923

75 - 79 15,195 0.0151947

80 + 15,445 0.0154446

Total 100 000 1

The Cumulative Risk 4

The cumulative rate is expressed as AThe cumulative rate =∑ ai ti i=1

The Cumulative risk =100 ×[1-exp (cumulative rate ⁄ 100)]


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OVERALL CANCER INCIDENCE

OVERALL CANCER INCIDENCE

EXECUTIVE SUMMARY

The Qatar National Cancer Registry (QNCR), at the Ministry of Public Health is the population based cancer registry for the State of Qatar, whose population in 2015 is recorded as 2,437,790.

There were 1466 newly diagnosed cancer cases reported during the year 2015, with a distribution of 18% Qataris, and 82% Non-Qataris. Cases were classified as follows:

Table 3: Basic Distribution of cancers by nationality and gender

Cancer Behavior

Non-Qatari Qatari GrandTotalF M Total F M Total

In situ 22 15 37 7 5 12 49

Malignant 478 677 1155 136 126 262 1417

Grand Total

500 692 1192 143 131 274 1466

Crude incidence rate was 58 per 100 000 and Age Standardized Rate ASR was 147 per 100 000 population at risk.

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MOST COMMON CANCERS ACROSS ALL NATIONALITIES AND GENDERS

Table 4: Comprehensive table of most common malignant cancers across all nationalities and genders

ICD 10 Primary Site

NGender Ratio

Median Age ASRCumulative Incidence risk

TOTAL F M F M F M All F M All F M All

C50 Breast 248 242 6 40.3 1.0 47.5 62 48 72.08 1.82 19.19 7.41 0.13 1.96

C18-C21 Colorectal 145 51 94 1.0 1.8 53 69 62 19.90 16.52 16.46 2.37 1.59 1.78

C61 Prostate 96 96 63 28.17 3.34

C82-C85, C96 NHL 83 21 62 1.0 3.0 52 50.5 51 6.70 9.81 8.28 0.63 1.09 0.90

C91-C95 Leukemia 82 17 65 1.0 3.8 9 34 29 2.99 10.37 7.50 0.22 0.80 0.62

C73 Thyroid gland 73 53 20 1.0 2.7 38 40 39 8.54 0.92 2.43 0.70 0.06 0.20

C33-C34 Trachea, bronchus and lung

72 19 53 1 2.8 55 60 59 8.35 12.99 10.90 1.02 1.49 1.29

C44 Non-Melanoma skin cancer

65 16 49 1.0 3.1 47.5 57 55.5 3.60 10.80 8.07 0.83 0.64 0.70

C22 Liver and intrahepatic bile ducts 54 7 47 1.0 6.7 59 57 57.5 3.50 9.37 7.36 0.37 0.88 0.75

C70-C72 Brain & CNS 48 12 36 1.0 3.0 30.5 38.5 34.5 1.84 4.05 3.20 0.14 0.48 0.36

MOST COMMON CANCER AMONGST MALES

The ten most common malignant cancers amongst males of all nationalities accounted for 561 cases or 70% of all male cancers in Qatar in 2015. Prostate cancer was the most common with 96 (11.96%) reported new cases. Colorectal cancer was the second most common with 94 (11.71%) reported new cases followed by Leukemia with 65 (8.09%) reported new cases.

Table 5: Most common malignant cancer among males of all nationalities

Order ICD 10 Primary Site N %

1 C61 Prostate 96 11.96%

2 C18-C21 Colorectal 94 11.71%

3 C91-C95 Leukemia 65 8.09%

4 C82-C85, C96 Non-Hodgkin Lymphoma 62 7.72%

5 C33-C34 Trachea, bronchus and lung 53 6.60%

6 C44 Non-Melanoma skin cancer 52 6.10%

7 C22 Liver and intrahepatic bile ducts 47 5.85%

8 C70-C72 Brain & CNS 36 4.48%

9 C64-C66, C68 Kidney 30 3.74%

10 C16 Stomach 29 3.61%

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MOST COMMON CANCER AMONGST FEMALES

The ten most common malignant cancers amongst females of all nationalities accounted for 537 cases or 87 % of all female malignant cancers. Breast cancer is the most common with 242 (39.41%) reported new cases, followed by the Thyroid gland with 53 (8.63%) new cases. Colorectal cancer was the next most common with 51 (8.31%) new cases.

Table 6: Most common malignant cancer among females of all nationalities


1 C50 Breast 242 39.41%

2 C73 Thyroid gland 53 8.63%


4 C54-C55 Uterus 40 6.51%

5 C56 Ovary 25 4.07%

5 C53 Cervix uteri 25 4.07%

6 C82-C85, C96 Non-Hodgkin Lymphoma 21 3.42%

7 C33-C34 Trachea, bronchus and lung 19 3.09%

8 C91-C95 Leukemia 17 2.77%


9 C16 Stomach 16 2.61%

10 C70-C72 Brain & CNS 12 1.95%

DISTRIBUTION BY NATIONALITY

When distributed according to nationality, 262 (18%) new cases of malignant cancer were Qataris and 1155(82 %) new cases were Non-Qataris.

Figure 3: Malignant cancer incidence distribution by nationality

DISTRIBUTION BY GENDER

Across all nationalities, new malignant cancer cases among males were found to be 803 (57%) cases of total malignant cancer cases, while females accounted for 614(43%) new cases.

Figure 4: Malignant cancer incidence distribution by gender

MALIGNANT CANCER INCIDENCE DISTRIBUTION BY NATIONALITY QATAR 2015

QATARI18%

NON-QATARI82%

QNCR: Qatar National Cancer Registry

MALIGNANT CANCER INCIDENCE DISTRIBUTION BY GENDER - QATAR 2015

FEMALE43%

MALE57%


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QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015

AGE STANDARDIZED INCIDENCE RATE ASIR

The calculation of ASIR (Age Standardized Incidence Rate) shows an increasing distribution of new cases with increased age, which reflects the international trend of cancer incidence.

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80+

0

400

600

200

800

1200

1000

1400

1600

ASI

R V

alue

s

Age Groups

AGE STANDARDIZED INCIDENCE RATE ASIR FOR MALIGNANT CANCER - QATAR 2015


Figure 5: Age Standardized Incidence Rate ASIR for all malignant cancers

CANCER INCIDENCE IN QATARIS

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CANCER INCIDENCE AMONGST QATARIS

A total of 262 newly diagnosed malignant cancers were reported amongst the Qatari population along with an additional 12 cases of in situ tumors. The majority of these cases were reported as single primaries. Only one case was reported with multiple primaries.

DEMOGRAPHIC DISTRIBUTION OF CANCER INCIDENCE

Distribution By Gender

Cancer in female Qataris was higher than that of males. During 2015, 126 (48%) new cases were diagnosed in males, while 136 (52%) new cases were diagnosed in females.

Figure 6: Cancer incidence by gender among Qataris

MOST COMMON CANCERS ACROSS ALL GENDERS

In the Qatari population newly diagnosed with cancer during 2015, the top ten malignant cancers accounted for 214 (82%) cases. Breast was the most common cancer with 52 (19.85%) new cases, followed by Colorectal with 31 (11.83%) new cases, Lung and Uterine with 17 (6.49%) new cases each. Prostate and Thyroid gland respectively were the fourth and fifth most common.

Table 7: Most common cancers across all genders of Qataris, 2015


1 C50 Breast 52 19.85%


3 C54-C55 Uterus 17 6.49%

3 C33-C34 Trachea, bronchus and lung

17 6.49%

4 C61 Prostate 14 5.34%


6 C70-C72 Brain & CNS 12 4.58%

7 C16 Stomach 11 4.20%

7 C91-C95 Leukemia 11 4.20%

8 C82-C85, C96 Non-Hodgkin Lymphoma

10 3.82%

9 C81 Hodgkin lymphoma 7 2.67%


10 C56 Ovary 6 2.29%

10 C64-C66, C68 Kidney 6 2.29%

MALIGNANT CANCER INCIDENCE DISTRIBUTION AMONG QATARIS BY GENDER - QATAR 2015

FEMALE52%

MALE48%


MOST COMMON CANCERS AMONGST MALES

Colorectal cancer accounted for 15 (11.9%) new cases and was the most common amongst Qatari males. Prostate and Lung cancers were both the second most common with 14 (11.11%) new cases each. Leukemia was the third most common cancer with 10 (7.94%) new cases.

Table 8: Most common cancers among male Qataris




14 11.11%

2 C61 Prostate 14 11.11%

3 C91-C95 Leukemia 10 7.94%

4 C70-C72 Brain & CNS 8 6.35%

4 C16 Stomach 8 6.35%


6 4.76%

6 C64-C66, C68 Kidney 5 3.97%


MOST COMMON CANCERS AMONGST FEMALES

The most common cancer amongst female Qataris was Breast with 50 (37%) new cases. The second most common was uterine cancer with 17 (12.5%) new cases and the third most common cancer was colorectal with 16 (11.76%) new cases. Thyroid gland and Ovarian respectively, were the fourth and fifth most common cancers.

Table 9: Most common cancers among female Qataris


1 C50 Breast 50 36.76%

2 C54-C55 Uterus 17 12.50%



5 C56 Ovary 6 4.41%

6 C70-C72 Brain & CNS 4 2.94%


4 2.94%


24

CANCER INCIDENCE IN NON-QATARIS

CANCER INCIDENCE AMONGST NON-QATARIS

A total of 1155 newly diagnosed malignant cancers were reported among the Non-Qatari population along with an additional 37 cases of in situ tumor. The majority of these cases were reported as single primaries. Only 2 cases reported with multiple primaries.

DEMOGRAPHIC DISTRIBUTION OF CANCER INCIDENCE

Distribution By Gender

Cancer presentations were higher in male Non-Qataris than in females. During 2015, 677 (59%) cases were newly diagnosed in males, while 478 (41%) new cases were diagnosed in females.

Figure 7: Cancer incidence by gender among Non-Qataris

MOST COMMON CANCERS ACROSS ALL GENDERS

In the Non-Qatari population newly diagnosed with cancer during 2015, the top ten malignant cancers accounted for a total of 794 (69%) cases. Breast was the most common cancer with 196 (16.97%) new cases, followed by Colorectal with 114 (9.87%) new cases and Prostate with 82 (7.10%) new cases. Non-Hodgkin Lymphoma and Leukemia respectively were fourth and fifth most common.

Table 10: Most common cancers across all genders of Non-Qataris


1 C50 Breast 196 16.97%


3 C61 Prostate 82 7.10%


73 6.32%

5 C91-C95 Leukemia 71 6.15%

6 C44 Non-Melanoma skin cancer

64 5.19%



55 4.76%

9 C22 Liver and intrahepatic bile ducts

49 4.24%

10 C70-C72 Brain & CNS 36 3.12%

MALIGNANT CANCER INCIDENCE DISTRIBUTION AMONG NON - QATARIS BY GENDER - QATAR 2015

FEMALE41%

MALE59%


27


MOST COMMON CANCERS AMONGST MALES

Prostate cancer accounted for 82 (12.11%) new cases and was the most common amongst Non-Qatari males. Colorectal cancer was the second most common with 79 (11.67%) new cases and Non-Hodgkin Lymphoma with 56 (8.27%) new cases were the third most common. Leukemia and Non-Melanoma skin cancer respectively were the fourth and fifth most common.

Table 11: Most common cancers among male Non-Qataris


1 C61 Prostate 82 12.11%



56 8.27%

4 C91-C95 Leukemia 55 8.12%



43 6.35%


39 5.76%

8 C70-C72 Brain & CNS 28 4.14%

9 C64-C66, C68 Kidney 25 3.69%

10 C16 Stomach 21 3.10%

MOST COMMON CANCERS AMONGST FEMALES

The most common cancer among Non-Qatari females was Breast with 192 (40.17%) new cases. The second most common was Thyroid gland with 43 (9.00%) new cases and the third most common cancer was Colorectal with 35 (7.32%) new cases. Uterine and Cervical respectively, were the fourth and fifth most common cancers.

Table 12: Most common cancers among female Non-Qataris


1 C50 Breast 192 40.17%



4 C54-C55 Uterus 23 4.81%

5 C53 Cervix uteri 22 4.60%

6 C56 Ovary 19 3.97%


17 3.56%


16 3.35%

8 C91-C95 Leukemia 16 3.35%

9 C44 Non-Melanoma skin cancer

14 2.93%

10 C16 Stomach 13 2.72%

COMPARATIVE STUDY

28 29


COMPARAISON WITH THE YEAR 2014

NUMBER OF CASES COMPARED TO 2014

Figure 8: Number of most common new cancer cases compared to the year 2014

MOST COMMON AMONG QATARIS, COMPARED TO 2014

Figure 9: Number of most common new cancer cases compared to the year 2014, among Qataris

Num

ber

of C

ases

Primary Site in ICD 10


C50Breast

237248

143 145

91 9679 82

6483

69 7258

73 64 65 7354 44 48

C18-C21Colorectal

C91-C95Leukemia

C82-C85C96 NHL

C33-C34Lung

C73ThyroidGland

C44 NMSkin Cancer

2014 2015

C22Liver

C70-C72Brain &

CNS

C61Prostate

NUMBER OF MOST COMMON NEW CANCER CASES COMPARED TO THE YEAR 2014

Num

ber

of C

ases

Primary Site in ICD 10


C50 B

reas

t

C18-C

21 C

olor

ecta

l C54

-C55

Ute

rus

C33-C

34 L

ung

C61 P

rost

ate

C73 T

hyro

id G

land

C70-C

72 B

rain

& C

NS

C16 S

tom

ach

C91-C

95 L

euke

mia

C82-C

85,C

96 N

HL

C81 H

odgk

in Iy

mph

oma

C44 N

on-M

elan

oma

Skin

Can

cer

C56 O

vary

C64-C

66,C

68 K

idne

y

54 52

39

31

9

1720

17

25

14 14 13 13 128

11 10 11 11 105 7 6 7

36 7 6

2014 2015

NUMBER OF MOST COMMON NEW CANCER CASES COMPARED TO THE YEAR 2014, AMONG QATARIS

ASIR DISTRIBUTION COMPARED TO 2014

Figure 10: ASIR Distribution compared to 2014

ASIR DISTRIBUTION AMONG QATARIS COMPARED TO 2014

Figure 11: ASIR Distribution among Qataris compared to 2014

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

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50-5

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60-6

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1000

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30002014 2015

2500

ASI

R v

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00 0

00

Age Groups



0-4

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4

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9

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Age Groups



30 31


ASIR DISTRIBUTION AMONG QATARIS COMPARED TO NON-QATARIS

Figure 13: ASIR Distribution comparaison across populations - Qatar 2015

Num

ber

of C

ases

Primary Site ICD 10

C50 B

reas

t

C18-C

21 C

olor

ecta

l C54

-C55

Ute

rus

C33-C

34 L

ung

C61 P

rost

ate

C73 T

hyro

id G

land

C70-C

72 B

rain

& C

NS

C16 S

tom

ach

C91-C

95 L

euke

mia

C82-C

85,C

96 N

HL

C81 H

odgk

in Iy

mph

oma

C44 N

on-M

elan

oma

Skin

Can

cer

C56 O

vary

C64-C

66,C

68 K

idne

y

379

106

218

7044

26

104

37

148

39

104

2767

25

71

19

126

21 2912

116

1336

9

62

13

140

21

Non-Qatari Qatari

NUMBER OF MOST COMMON NEW CANCER CASES DURING 2015 AMONG QATARIS COMPARED TO NON-QATARIS

0-4

5-9

10-1

4

15-1

9

20-2

4

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9

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Qatari Non-Qatari

2500

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00 0

00

Age Groups

ASIR DISTRIBUTION COMPARAISON ACROSS POPULATIONS - QATAR 2015


All

MOST COMMON AMONG QATARIS, COMPARED TO NON-QATARIS

Figure 12: Number of most common new cancer cases during 2015 among Qataris compared to Non-Qataris

COMPARAISON WITH NON-QATARIS

Reference to the most recent available cancer data estimates, that is Globocan 2012, the following comparisons help positioning the cancer burden in the State of Qatar compared to international and regional countries

Crude Rate

Figure 14: Crude rate of incidence in Qatar 2015 compared to regional countries Age – Specific Incidence Rate (ASIR)

Cumulative RIsk of Incidence [0-74]

Based on the estimates of Globocan -2012 and using the QNCR data for Qatar 2015, we can see higher risk of getting cancer among Qataris during the age life of 0-74 years old, compared to regional countries

Figure 15: cumulative risk of incidence in Qatar 2015 compared to regional

Age Standardized Rate ASR

ASR measure among Qataris in 2015 shows higher rate compared to regional countries, data based on estimates of Globocan 2012

Figure 16: ASR in Qatar 2015 compared to regional countries

0UAE- 2012 KSA- 2012 OMAN- 2012 KUWAIT- 2012 ALL GULF- 2012 EMRO

REGION-2012QATAR 2015

20

30

10

40

60

50

70

90

100

80

Cru

de

Inci

den

ce R

ate

per

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000

Countries

CRUDE RATE ESTIMATES PER 100 000 OF ALL CANCER EXCLUDING NON-MELANOMA SKIN



10

15

5

20

25

Cum

ulat

ive

Ris

k [0

-74]

Countries

CUMULATIVE RISK [0-74] OF INCIDENCE OF ALL CANCER EXCLUDING NON-MELANOMA SKIN



40

60

80

100

120

140

20

160

180

ASR

per

100

000

Countries

ASR ESTIMATES PER 100 000 OF ALL CANCER EXCLUDING NON-MELANOMA SKIN

INTERNATIONAL PERSPECTIVE


32

PEDIATRIC CANCER INCIDENCE

PEDIATRIC CANCER INCIDENCE

Within the age range of 0-14 years, there were 54 cases newly diagnosed with cancer during 2015.

DISTRIBUTION BY NATIONALITY

When distributed according to nationality, 12 (22%) new cases were Qataris, and 42(78%) new cases were Non-Qataris.

Figure 17: Pediatric cancer incidence distribution by nationality

DISTRIBUTION BY GENDER

Across all nationalities, gender distribution shows 34(63%) new cases were found in males and 20 (37%) new cases in females.

Figure 18: Pediatric cancer incidence distribution by gender

PEDIATRIC CANCER INCIDENCE DISTRIBUTION BY NATIONALITY - QATAR 2015

QATARI22%

NON-QATARI78%


PEDIATRIC CANCER INCIDENCE DISTRIBUTION BY GENDER - QATAR 2015

FEMALE37%

MALE63%


35


MOST COMMON PEDIATRIC CANCERS

The most common cancer amongst pediatrics was Leukemia with 25 (46.30%) new cases. The second most common was Brain & CNS with 13 (24.07%) new cases followed by Non-Hodgkin Lymphoma with 6 (11.11%) new cases.

Table 13: Most common cancers among pediatrics


1 C91-C95 Leukemia 25 46.30%

2 C70-C72 Brain & CNS 13 24.07%


6 11.11%

CANCER DEATHS

36 37


CANCER DEATH

During the year 2015, there were 264 deaths amongst cancer patients, among which are 79(30%) Qataris and 185(70%) Non-Qataris.

Amongst Qatari population, the Age Standardized Rate ASR for death was 56.6 per 100 000, while the cumulative risk of death within the age range of 0-74 years old was 10.14%.

MOST COMON CANCER DEATHS AMONGST QATARIS

Among Qataris, Breast was behind the death of 15 cases, at a percentage of 18.99% of all deaths related to cancer during the year 2015, followed by Lung with 13(16.46%) cases and Colorectal with 10(12.66%) cases.

Table 14: Most common cancer deaths among Qataris


1 C50 Breast 15 18.99%


13 16.46%



7 8.86%

5 C16 Stomach 5 6.33%

6 C61 Prostate 4 5.06%

MOST COMON CANCER DEATHS AMONGST PEDIATIRC

Amongst pediatric population of the age range 0-14 years old, 6 cases died during the year 2015, 50% of these cases were related to brain tumors.


38

MOST COMMON CANCERS DEMOGRAPHICS

• By Nationality:• Qatari: 262 new cases, of which 126 are males and

136 females• Non-Qatari: 1155 cases, of which 677 are males

and 478 females• By Age:

• Median age was 50 years (53 for Qataris)• Peak Incidence was in the age group of 50-54

years (55-59 for Qataris)• More than 50% of the cases were diagnosed

above the age of 45 years ( 55 for Qataris)• Lowest age at diagnosis: 0 years, less than a year • Highest age at diagnosis: 91 years

DEMOGRAPHICS

• By Nationality:• Qatari: 262 new cases, of which 126 are males and

136 females• Non-Qatari: 1155 cases, of which 677 are males

and 478 females• By Age:

• Median age was 50 years (53 for Qataris)• Peak Incidence was in the age group of 50-54

years (55-59 for Qataris)• More than 50% of the cases were diagnosed

above the age of 45 years ( 55 for Qataris)• Lowest age at diagnosis: 0 years, less than a year • Highest age at diagnosis: 91 years

ALL CANCERS C00-C96

BASIS OF DIAGNOSIS

Table 15: Basis of diagnosis of malignant cancers

Basis of Diagnosis %

Histology of primary 91.25%

DCO (Death Certificate Only ) 4.87%

Clinical Investigation/Ultra Sound 2.61%

Histology of metastasis 0.71%

Unknown 0.56%

PREVALENCE

The Qatari population registered in the QNCR, there were 3683 newly diagnosed cases with malignant cancer. Of these cases, 1376 (37%) have died and 2307 (63%) are still alive.

DEATH

Out of the 262 Qatari cases diagnosed during 2015 with malignant cancer, 40 (15%) cases died during the same year.

40 41


KEY FACTS

In 2015, there were 248 newly diagnosed cases of malignant breast cancer, 6 of which were males and 242 were females.

Female breast cancer ranked first amongst all new cases of female malignant cancers with 39.41%.

The cumulative risk, or the chance of a female getting malignant breast cancer between the ages of 0-74, is 7.4%.The Age Standardized Rate (ASR) was found to be 72.08 per 100 000 of population at risk.

DEMOGRAPHICS

• By Nationality:• Qatari: 52 cases, of which 2 are males• Non-Qatari: 196 cases, of which 4 are males

• By Age: • Median age was 48 years• Peak Incidence was in the age group of 40-49

years• More than 50% of the cases were diagnosed under

the age of 49 years• Lowest age at diagnosis: 27 years• Highest age at diagnosis: 82 years

C50 BREAST

PREVALENCE

Amongst the female Qatari population registered in the QNCR, there were 649 newly diagnosed cases with malignant breast cancer. Of these cases, 155 (24%) have died and 494 (76%) are still alive.

HISTOLOGY

Table 16: ICDO-3 Histology distribution of female malignant breast cancer

ICD-O-3 Histology %

Infiltrating duct carcinoma, NOS 88.02%

Lobular carcinoma, NOS 5.79%

Infiltrating ductular carcinoma 1.65%

Phyllodes tumor, malignant 0.83%

Mucinous adenocarcinoma 0.83%

Others 3%

STAGING

Almost 56% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 66% were early stages I and II. [PLEASE SEE DISCLAIMER]

Figure 19: cTNM group staging for female malignant breast cancer

TREATMENT

In 2015, only 168 (69%) of total cases were reported with treatment information. The following table shows the treatment types in no chronological order. [PLEASE SEE DISCLAIMER]

Table 17: Treatment types for female malignant breast cancer

Treatment Type %

Surgery/ 39.88%

Surgery/ Chemotherapy 30.95%

Chemotherapy 17.86%

Surgery/ Radiation 4.17%

Surgery/Radiation/ Chemotherapy 3.57%

Radiation/ Chemotherapy /Hormonal 1.19%

Radiation/ Hormonal 1.19%

Chemotherapy/ Radiation 0.60%

Surgery/ Chemotherapy / Hormonal 0.60%

DEATH

Out of the 50 Qatari cases diagnosed during 2015 with malignant female breast cancer, 5 (10%) cases died during the same year. Only one of these 5 cases reported a known cTNM stage of stage IV. The age range for these deaths was from 40 to above 80 years old.

3-YEAR SURVIVAL 2013-2015

3-year survival from female breast cancer during the period 2013-2015 was relatively high at 82.3% with a confidence interval (CI) of 69.6% - 90.1%.

Survival calculations do not take into consideration different variables such as cTNM stage.

0%I II III IV

10%

15%

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20%

30%

25%

35%

40%

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CTNM DISTRIBUTION FOR FEMALE BREAST CANCER - QATAR 2015


30%

36%

21%

13%

42 43


C18-C21 COLORECTAL

KEY FACTS

In 2015, there were 145 newly diagnosed cases of malignant colorectal cancer, 31 (21%) cases of which were Qataris and 114 (78%) cases Non-Qataris.

Colorectal cancer ranked the second most common amongst males with 94 new cases (11.71%) and was the third most common cancer amongst females with 51 (8.31%) new cases.

The cumulative risk, or the chance of any person getting colorectal cancer between the ages of 0-74, is 1.78%.The Age Standardized Rate (ASR) was found to be 16.46 per 100 000 of population at risk.

DEMOGRAPHICS

• By Nationality• Qatari: 31 cases, of which 15 were males and 16

were females• Non-Qatari: 114 cases, of which 79 were males and

35 were females• By Age:

• Median age overall was 62 years (69 for males and 53 for females)

• Peak Incidence was in the age group of 50-59 years• More than 50 % of cases were diagnosed over the

age of 55 years• Lowest age at diagnosis: 31 years• Highest age at diagnosis: 80 years

PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 377 newly diagnosed cases with malignant colorectal cancer. Of these cases, 125 (33%) have died and 252 (67%) are still alive.

HISTOLOGY

Table 18: Histology distribution for malignant colorectal cancer

ICDO-3 Histology %

Adenocarcinoma, NOS 78.62%

Mucinous adenocarcinoma 4.83%

Carcinoid tumor, NOS 3.45%

Neuroendocrine carcinoma, NOS 2.76%

Neoplasm, malignant 2.76%

Signet ring cell carcinoma 2.07%

Squamous papillomatosis 1.38%

Gastrointestinal stromal sarcoma 0.69%

Primitive neuroectodermal tumor, NOS 0.69%

Tubular adenocarcinoma 0.69%

Carcinoma, NOS 0.69%

Leiomyosarcoma, NOS 0.69%

Goblet cell carcinoid 0.69%

STAGING

Almost 25% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 68% were late stages III and IV. [PLEASE SEE DISCLAIMER]

Figure 20: cTNM distribution for malignant colorectal cancer

TREATMENT


Table 19: Treatment types for malignant colorectal cancer

Treatment Type %

Surgery 55.68%

Surgery/Chemotherapy 18.18%

Chemotherapy 14.77%

Chemotherapy/Radiation 7.95%

Radiation 2.27%

Surgery/Radiation/Chemotherapy 1.14%

DEATH

Out of the 31 Qatari cases diagnosed during 2015 with colorectal cancer, 5 (16%) of which died during the same year.


3-year survival from colorectal cancer during the period 2013-2015 was relatively high at 69.2% (CI 50.4% - 82.1%).

Survival calculations do not take into consideration different variables such as cTNM stage or gender.

0%I II III IV

10%

15%

5%

20%

30%

25%

35%

40%

45%

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CTNM DISTRIBUTION FOR COLORECTAL CANCER - QATAR 2015


11%

21%

41%

27%

44 45


C61 PROSTATE

KEY FACTS

In 2015, there were 96 newly diagnosed cases of malignant prostate cancer, 14 (15%) of which were Qataris and 82 (85%) were Non-Qataris.

Prostate cancer ranked first amongst all new cases of male malignant cancers with 11.96%.

The cumulative risk, or the chance of a male getting malignant prostate cancer between the ages of 0-74, is 3.34% Age Standardized Rate (ASR) was found to be 28.17 per 100 000 of population at risk.

DEMOGRAPHICS

• By Age: • Median age was 63 years• Peak Incidence was in the age group of 60-64 years

(27.08%)• More than 50 % of the cases were diagnosed over


PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 165 newly diagnosed cases with malignant prostate cancer. Of these cases, 49 (25%) have died and 116 (75%) are still alive.

HISTOLOGY

Table 20: Histology distribution for malignant prostate cancer

ICDO-3 Histology %


Acinar cell carcinoma 2.08%



STAGING

Almost 64% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 57% were late stages III and IV. [PLEASE SEE DISCLAIMER]

Figure 21: cTNM Distribution for malignant prostate cancer

TREATMENT


Table 21: Treatment types for malignant prostate cancer

Treatment Type %

Surgery 62.50%

Hormonal 12.50%

Chemotherapy 9.38%

Surgery/ Radiation 6.25%

Chemo/Radiation 3.13%

Radiation/Hormonal 3.13%

DEATH

All 14 Qatari cases diagnosed during 2015 with malignant prostate cancer are still alive.


3-year survival from prostate cancer during the period 2013-2015 was relatively high at 81.8% (CI 53.6% - 93.7%).

0%II IVIII

10%

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5%

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30%

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35%

40%

45%

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CTNM DISTRIBUTION FOR PROSTATE CANCER - QATAR 2015


43%

23%

34%

C82-C85, C96 NON-HODGKIN LYMPHOMA

KEY FACTS

In 2015, there were 83 newly diagnosed cases of malignant Non-Hodgkin Lymphoma, 10 (12%) cases of which were Qataris and 73 (88%) cases Non-Qataris.

Non-Hodgkin Lymphoma was the fourth most common cancer amongst males with 62 new cases (7.72%) and it was the seventh most common cancer amongst females with 21 (3.42%) new cases.

The cumulative risk, or the chance of any person getting a Non-Hodgkin Lymphoma between the ages of 0-74, is 0.9%.

The Age Standardized Rate (ASR) was found to be 8.28 per 100 000 of population at risk.

DEMOGRAPHICS

• By Nationality:• Qatari: 10 cases, of which 6 were male and 4 were

female• Non-Qatari: 73 cases, of which 56 were male and 17

were female• By Age:

• Median age was 51 years (50 years for males and 52 years for females)

• Peak Incidence was in the age group of 50-54 years• More than 50% of the cases were diagnosed over


PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 188 newly diagnosed cases with Non Hodgkin Lymphoma. Of these cases, 48 (26%) have died and 140 (76%) are still alive.

HISTOLOGY

Table 22: Histology distribution for non-Hodgkin Lymphoma

ICDO-3 Histology %

Malignant lymphoma, large B-cell, diffuse, NOS

50.60%

Malignant lymphoma, non-Hodgkin, NOS 18.07%

Follicular lymphoma, NOS 10.84%

Precursor T-cell lymphoblastic lymphoma 3.61%

Anaplastic large cell lymphoma, T cell and Null cell type

3.61%

Malignant lymphoma, NOS 2.41%

Langerhans cell sarcoma 2.41%

Malignant lymphoma, small B lymphocytic, NOS

1.20%

Burkitt lymphoma, NOS 1.20%

Mature T-cell lymphoma, NOS 1.20%


Follicular dendritic cell sarcoma 1.20%

Composite Hodgkin and non-Hodgkin lymphoma

1.20%

Malignant lymphoma, lymphoplasmacytic 1.20%

46 47


STAGING

Almost 92% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 86% were late stages IV. [PLEASE SEE DISCLAIMER]

Figure 22: cTNM Distribution for non-Hodgkin Lymphoma

0%III IV

20%

30%

10%

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60%

50%

70%

80%

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CTNM DISTRIBUTION FOR NON-HODGKIN LYMPHOMA - QATAR 2015


14%

86%

TREATMENT

In 2015, only 21(25%) of total cases were reported with treatment information. The following table shows the treatment types in no chronological order. [PLEASE SEE DISCLAIMER]

Table 23: Treatment types for non-Hodgkin Lymphoma

Treatment Type %

Chemotherapy 85.71%

Surgery 4.76%

Surgery/Chemotherapy 4.76%

Chemotherapy/Radiation 4.76%

DEATH

All 10 Qatari cases diagnosed during 2015 with a Non-Hodgkin Lymphoma are still alive.


3-year survival from Non-Hodgkin Lymphoma during the period 2013-2015 was relatively high at 79.0% (CI 38.7% - 94.3%)

C91-C95 LEUKEMIA

KEY FACTS

In 2015, there were 82 cases newly diagnosed with a Leukemia, 11 (13%) of which were Qataris and 71 (87%) were Non-Qataris.

Leukemia was the third most common cancer amongst males with 65 new cases (11.52%), and it was the ninth most common cancer amongst females with 17 (2.77%) new cases.

The cumulative risk, or the chance of any person getting Leukemia between the ages of 0-74, is 0.62%.The Age Standardized Rate (ASR) was found to be 7.5 per 100 000 of population at risk.

DEMOGRAPHICS

• By Nationality:• Qatari: 11 cases, of which 10 were male and 1 was

female• Non-Qatari: 71 cases, of which 55 were male and 16

were female• By Age:

• Median age was 29 years (34 years for males and 9 years for females)

• Peak Incidence was in the age group of 0-4 years• More than 50% of the cases were diagnosed under

the age of 25 years• Lowest age at diagnosis: 2 years• Highest stage at diagnosis: 90 years

PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 169 newly diagnosed cases with Leukemia. Of these cases, 56 (33%) have died and 113 (67%) are still alive.

HISTOLOGY

Table 24: Histology distribution for leukemia

ICDO-3 Histology %

Acute myeloid leukemia, NOS (FAB or WHO type not specified, see also M-9930/3)

30.49%

Precursor B-cell lymphoblastic leukemia 30.49%

Chronic myeloid leukemia, NOS 10.98%

Precursor T-cell lymphoblastic leukemia 8.54%

B-cell lymphocytic leukemia/small lymphocytic lymphoma

8.54%

Acute promyelocytic leukaemia, t(15;17)(q22;q11-12)

4.88%

Precursor cell lymphoblastic leukemia, NOS 3.66%

Adult T-cell leukemia/lymphoma (HTLV-1 positive) (includes all variants)

1.22%

Hairy cell leukemia (C42.1) 1.22%

DEATH

Out of the 11 Qatari cases diagnosed during 2015 with Leukemia, 1 (9%) case died during the same year.


3-year survival from leukemia during the period 2013-2015 was 57.1% (CI 17.2% - 83.7%).

C91-C95 LEUKEMIA

48 49


C73 THYROID GLAND

KEY FACTS

In 2015, 73 cases were newly diagnosed with malignant thyroid cancer, 13(18%) of which were Qataris and 60(82%) cases Non-Qataris.

Thyroid cancer ranked second among most common female malignant cancer with 53(8.63%) new cases.

The cumulative risk is 0.2% (0.7 % for females), that relates to the chance of a person to get malignant thyroid cancer during the age of 0-74

Age Standardized Rate ASR found to be 2.4 (8.5 for females) per 100 000 of population at risk

DEMOGRAPHICS

• By Nationality:• Qatari: 13 cases, of which 3 are among males and 10

among females• Non-Qatari: 60 cases, of which 17 are among males

and 43 among females• By Age:

• median age was 39 (40 for males, and 38 for females)• Peak of Incidence was in the age group of 35-39,

earlier for females, 25-29• More than 50 % of the cases were diagnosed under

the age of 35• Min age: 16• Max age: 62

PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 185 newly diagnosed cases with malignant thyroid cancer. Of these cases, 15 (8%) have died and 170 (82%) are still alive.

HISTOLOGY

Table 25 : Histology distribution for malignant thyroid cancer

ICDO-3 Histology %

Papilloma, NOS 53.42%

Papillary adenocarcinoma, NOS 35.62%

Papillary microcarcinoma 5.48%

Follicular adenocarcinoma, NOS 2.74%


Medullary carcinoma, NOS 1.37%

STAGING

Almost 64% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 81% were early stage I. [PLEASE SEE DISCLAIMER]

Figure 23: cTNM Distribution for malignant thyroid cancer

DEATH

All cases diagnosed during 2015 with malignant thyroid cancer among Qataris, are still alive.


3-year survival from malignant thyroid cancer during the period 2013-2015 was very high 90.0% (47.3% - 98.5%)

0%I III IV

20%

30%

10%

40%

60%

50%

70%

80%

90%

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CTNM DISTRIBUTION FOR THYROID CANCER - QATAR 2015


81%

12% 8%

C33-C34 TRACHEA, BRONCHUS AND LUNG

KEY FACTS

In 2015, 72 cases were newly diagnosed with malignant lung cancer, 17(24%) of which were Qataris and 55(76%) Non-Qataris.

Lung cancer with 53 new cases ranked fifth among most common male malignant cancers with percentage of 6.60%, and ranked eight among most common female malignant cancer with 19(3.09%) new cases.

The cumulative risk is 1.29%, that relates to the chance of a person to get malignant Lung cancer during the age of 0-74

Age Standardized Rate ASR found to be 10.9 per 100 000 of population at risk

DEMOGRAPHY




• omedian age was 59 (60 for males, and 55 for females)

• Peak of Incidence was in the age group of 55-59• More than 50 % of the cases were diagnosed over


PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 210 newly diagnosed cases with malignant lung cancer. Of these cases, 164 (78%) have died and 46 (22%) are still alive.

HISTOLOGY

Table 26: Histology distribution for malignant lung cancer

ICDO-3 Histology %


Non-small cell carcinoma 12.50%




Small cell carcinoma, NOS 4.17%

Carcinoid tumor, NOS 2.78%

Carcinoma, NOS 1.39%

Papillary adenocarcinoma, NOS 1.39%

50 51


STAGING

Almost 50% of the total cases reported in 2015 did not have a known cTNM stage. Of those cases that did report a cTNM stage, 83% were late stage IV. [PLEASE SEE DISCLAIMER]

Figure 24: cTNM Distribution for malignant lung cancer

0%I III IV

20%

30%

10%

40%

60%

50%

70%

80%

90%

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CE

cTNM Groups

CTNM DISTRIBUTION FOR LUNG CANCER - QATAR 2015


6% 11%

83%

TREATMENT


Table 27: Treatment types for malignant lung cancer

Treatment Type %

Chemo 50.00%

Chemo/Radio 35.00%

Surgery/ 10.00%

Radiation 5.00%

DEATH

Out of the 17 Qatari cases diagnosed during 2015 with malignant lung cancer, 9(53%) cases died. The only case with known cTNM stage was at stage IV. Age rang for these deaths was 44-80+


3-year survival from malignant lung cancer during the period 2013-2015 was relatively law 25.0% (11.1% - 41.8%)

C44 NON-MELANOMA SKIN CANCER

KEY FACTS

In 2015, 65 cases were newly diagnosed with non-melanoma skin cancer, 7(11%) of which were Qataris and 58(89%) cases Non-Qataris.

Non-melanoma skin cancer with 49 new cases ranked sixth among most common male malignant cancers with percentage of 6.10%, and ranked tenth among most common female malignant cancer with 16(2.61 %) new cases

The cumulative risk is 0.7% that relates to the chance of a person to get malignant non-melanoma skin cancer during the age of 0-74

Age Standardized Rate ASR found to be 8(10.8 for males) per 100 000 of population at risk

DEMOGRAPHY




• median age was 55.5 (57 for males, and 47.5 for females)



PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 94 newly diagnosed cases with non-melanoma skin cancer. Of these cases, 10 (11%) have died and 84 (89%) are still alive.

HISTOLOGY

Table 28: Histology distribution for non-melanoma skin cancer

ICDO-3 Histology %

Basal cell carcinoma, NOS 43.06%


Basal cell carcinoma, nodular 9.72%

Dermatofibrosarcoma, NOS 5.56%

Basosquamous carcinoma 4.17%

Haemangiosarcoma 2.78%

Synovial sarcoma, NOS 1.39%

Infiltrating duct carcinoma, NOS 1.39%

Eccrine papillary adenocarcinoma 1.39%

Paget disease, mammary 1.39%

DEATHAll of the 7 Qatari cases diagnosed during 2015 with non-melanoma skin cancer, are alive.


3-year survival from malignant non-melanoma skin cancer during the period 2013-2015 was relatively high 81.8% (24.0% - 97.2%)

52 53


C22 LIVER AND INTRAHEPATIC BILE DUCTS

KEY FACTS

In 2015, 54 cases were newly diagnosed with malignant liver cancer, 5(9%) of which were Qataris and 49(91%) Non-Qataris.

Liver cancer with 47 new cases ranked seventh among most common male malignant cancers with percentage of 5.85%.

The cumulative risk is 0.75%, that relates to the chance of a person to get malignant liver cancer during the age of 0-74


DEMOGRAPHY




• median age was 57.5 (57 for males, and 59 for females)


the age of 55• Min age: 0 (less than a year)• Max age: 86

PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 162 newly diagnosed cases with malignant liver cancer. Of these cases, 131 (81%) have died and 31 (19%) are still alive.

HISTOLOGY

Table 29: Histology distribution for malignant liver cancer

ICDO-3 Histology %


Hepatocellular carcinoma, NOS 29.63%

Cholangiocarcinoma 9.26%

Hepatoblastoma 1.85%

DEATH

Out of the 5 Qatari cases diagnosed during 2015 with malignant liver cancer, 3(60%) cases died, and 2 (40%) cases are still alive.


3-year survival from malignant liver cancer during the period 2013-2015 was relatively low 18.8% (4.6% - 40.3%)

C70-C72 BRAIN & CNS

KEY FACTS

In 2015, 48 cases were newly diagnosed with malignant brain cancer, 12(25%) of which were Qataris and 36(75%) Non-Qataris.

Brain cancer with 36 new cases ranked eighth among most common male malignant cancers with percentage of 4.48%.

The cumulative risk is 0.36% that relates to the chance of a person to get malignant brain cancer during the age of 0-74


DEMOGRAPHY




• median age was 34.5 (38.5 for males, and 30.5 for females)

• Peak of Incidence was in the age group of 0-4• More than 50 % of the cases were diagnosed under

the age of 35• Min age: 0 (less than 1 year)• Max age: 73

PREVALENCE

Amongst the Qatari population registered in the QNCR, there were 116 newly diagnosed cases with malignant brain cancer. Of these cases, 62 (53%) have died and 54 (47%) are still alive.

HISTOLOGY

Table 30: Histology distribution for malignant brain cancer

ICDO-3 Histology %

Glioblastoma 25.00%

Oligodendroglioma, anaplastic 18.75%

Oligodendroglioma, NOS 8.33%

Neuroblastoma, NOS 6.25%

Medulloblastoma, NOS 4.17%

Gliosarcoma 4.17%

Fibrillary astrocytoma 4.17%


Atypical teratoid/rhabdoid tumor 4.17%

Mixed glioma 2.08%

Neurilemoma, malignant 2.08%

Ependymoma, NOS 2.08%

Ependymoma, anaplastic 2.08%

Choroid plexus carcinoma 2.08%

Ganglioglioma, anaplastic 2.08%

Astrocytoma, NOS 2.08%

Primitive neuroectodermal tumor, NOS 2.08%

Astrocytoma, anaplastic 2.08%

Glioma, malignant 2.08%

55


TREATMENT


Table 31: Treatment types for malignant brain cancer

Treatment Type %

Surgery/ 60.87%

Surgery/Radiation/Chemo 21.74%

Chemo 8.70%

Radiation 4.35%

Surgery/Chemo 4.35%

DEATH

Out of the 12 Qatari cases diagnosed during 2015 with malignant female breast cancer, 2(17%) cases died and 10(83%) cases are still alive.


3-year survival from malignant brain cancer during the period 2013-2015 was 53.9% (24.8% - 76.0%)

APPENDICES

56 57


APPENDICE 1

FACT SHEET ON ALL CANCERS IN QATAR DURING 2015

• Including Non-Melanoma skin cancers (C44)• There were 1417 newly diagnosed cases of

malignant cancer, 262 (18.5%) of which were Qataris and 1155 (81.5%) Non-Qataris.

• There were 49 newly diagnosed cases of In situ cancer, 12 (24.5%) of which were Qataris and 37 (75.5%) Non-Qataris.

• Crude incidence rate was 58 per 100 000 and Age Standardized Rate ASR was 147 per 100 000 population at risk of all nationalities.

• For Qataris, crude incidence rate was 93 per 100 000 and Age Standardized Rate ASR was 156 per 100 000 population at risk.

• For all nationalities, the cumulative risk, or the chance of a getting malignant cancer between the ages of 0-74, is 14.35%.

• For Qataris, the cumulative risk, or the chance of a getting malignant cancer between the ages of 0-74, is 21.34%.

• Excluding Non-Melanoma skin cancers (C44)• There were 1352 newly diagnosed cases of

malignant cancer, 255 (18.86%) of which were Qataris and 1097 (81.14%) Non-Qataris.

• Crude incidence rate was 55.46 per 100 000 and Age Standardized Rate ASR was 104 per 100 000 population at risk of all nationalities.

• For Qataris, crude incidence rate was 90.3 per 100 000 and Age Standardized Rate ASR was 153 per 100 000 population at risk.

• For all nationalities, the cumulative risk, or the chance of a getting malignant cancer between the ages of 0-74, is 10.62%.

• For Qataris, the cumulative risk, or the chance of a getting malignant cancer between the ages of 0-74, is 21.18%.

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810

816

1310

65

6<

399

C19

Mal

igna

nt n

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lasm

o

f rec

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gm

oid

junc

tion

<3

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3<

34

<3

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15

C20

Mal

igna

nt n

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o

f rec

tum

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35

43

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53

<3

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29

C21

Mal

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nt n

eop

lasm

o

f anu

s an

d a

nal c

anal

<3

<3

<3

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C22

Mal

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nt n

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f liv

er a

nd in

trah

epat

ic

bile

duc

ts<

3<

33

44

515

75

33

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54

C23

Mal

igna

nt n

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f gal

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dd

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34

<3

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9

C24

Mal

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f oth

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nd u

nsp

ecifi

ed

par

ts o

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ary

trac

t<

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35

C25

Mal

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nt n

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o

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crea

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34

43

5<

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320

C26

Mal

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f oth

er a

nd il

l-defi

ned

d

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tive

org

ans

<3

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C30

Mal

igna

nt n

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lasm

o

f nas

al c

avity

and

mid

dle

ea

r<

3<

3

C31

Mal

igna

nt n

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lasm

o

f acc

esso

ry s

inus

es<

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3

C32

Mal

igna

nt n

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lasm

o

f lar

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6

MA

LIG

NA

NT

CA

SES

DIS

TRIB

UTI

ON

BY

AG

E G

RO

UP

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CR

OSS

ALL

NA

TIO

NA

LITI

ES

ICD

10

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C34

Mal

igna

nt n

eop

lasm

o

f bro

nchu

s an

d lu

ng<

33

311

912

119

73

372

C37

Mal

igna

nt n

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lasm

o

f thy

mus

<3

<3

<3

<3

5

C38

Mal

igna

nt n

eop

lasm

o

f hea

rt, m

edia

stin

um

and

ple

ura

<3

<3

C40

Mal

igna

nt n

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lasm

o

f bo

ne a

nd a

rtic

ular

ca

rtila

ge

of l

imb

s<

3<

33

<3

<3

<3

<3

11

C41

Mal

igna

nt n

eop

lasm

o

f bo

ne a

nd a

rtic

ular

ca

rtila

ge

of o

ther

and

un

spec

ified

site

s

<3

<3

<3

<3

<3

<3

<3

<3

9

C43

Mal

igna

nt

mel

ano

ma

of s

kin

<3

<3

<3

<3

<3

4<

315

C44

Oth

er a

nd

unsp

ecifi

ed m

alig

nant

ne

op

lasm

of s

kin

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56

510

157

4<

33

4<

365

C45

Mes

oth

elio

ma

<3

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C48

Mal

igna

nt n

eop

lasm

o

f ret

rop

erito

neum

and

p

erito

neum

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C49

Mal

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ectiv

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d

soft

tis

sue

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312

C50

Mal

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nt n

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lasm

o

f bre

ast

412

3245

4538

2620

135

44

248

C53

Mal

igna

nt n

eop

lasm

o

f cer

vix

uter

i<

3<

3<

34

93

<3

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25

MA

LIG

NA

NT

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TRIB

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64 65


ICD

10

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C54

Mal

igna

nt n

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lasm

o

f co

rpus

ute

ri<

3<

3<

33

46

144

<3

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38

C55

Mal

igna

nt

neo

pla

sm o

f ute

rus,

par

t un

spec

ified

<3

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C56

Mal

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nt n

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lasm

of

ova

ry<

3<

3<

3<

3<

35

<3

34

<3

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25

C60

Mal

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3

C61

Mal

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stat

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33

814

2624

107

396

C62

Mal

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3<

34

4<

3<

3<

3<

315

C64

Mal

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nt n

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asm

of

kidn

ey, e

xcep

t ren

al p

elvi

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3<

3<

33

69

76

<3

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40

C67

Mal

igna

nt n

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lasm

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f bla

dd

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3<

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34

43

3<

3<

3<

321

C71

Mal

igna

nt n

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lasm

o

f bra

in9

<3

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45

53

43

3<

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346

C72

Mal

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nt n

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o

f sp

inal

co

rd, c

rani

al

nerv

es a

nd o

ther

par

ts o

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l ner

vous

sys

tem

<3

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C73

Mal

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nt n

eop

lasm

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f thy

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nd3

412

1213

128

6<

3<

373

C74

Mal

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nt n

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rena

l gla

nd<

3<

3

C76

Mal

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nt n

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asm

of

oth

er a

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l-defi

ned

site

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3

MA

LIG

NA

NT

CA

SES

DIS

TRIB

UTI

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BY

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RO

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LITI

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ICD

10

Pri

mar

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tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C80

Mal

igna

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asm

w

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t spe

cific

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n of

site

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4<

34

<3

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321

C81

Ho

dg

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lym

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ma

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35

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20

C82

Fo

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lar

lym

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3<

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39

C83

No

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lym

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34

4<

38

75

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348

C84

Mat

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T/N

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pho

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4

C85

Oth

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ified

and

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spec

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n-H

od

gki

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mp

hom

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3<

3<

33

<3

3<

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317

C86

Oth

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of T

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mp

hom

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3<

3

C88

Mal

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uno

pro

lifer

ativ

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ses

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tain

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B-c

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hom

a

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3

C90

Mul

tiple

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lom

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alig

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pla

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cell

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pla

sms

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3<

38

C91

Lym

pho

id le

ukem

ia11

63

4<

3<

33

<3

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3<

3<

3<

3<

344

C92

Mye

loid

leuk

emia

3<

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3<

35

53

5<

34

<3

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38

MA

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NT

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ALL

NA

TIO

NA

LITI

ES

66 67

QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015M

ALI

GN

AN

T C

ASE

S D

ISTR

IBU

TIO

N B

Y A

GE

GR

OU

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AC

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ICD

10

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C96

Oth

er a

nd

unsp

ecifi

ed m

alig

nant

ne

op

lasm

s o

f lym

pho

id,

hem

ato

po

ietic

and

re

late

d t

issu

e

<3

<3

<3

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5

D42

Neo

pla

sm o

f un

cert

ain

beh

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r o

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enin

ges

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D45

Po

lycy

them

ia v

era

<3

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<3

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5

D47

Oth

er n

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lasm

s o

f unc

erta

in b

ehav

ior

of

lym

pho

id, h

emat

op

oie

tic

and

rela

ted

tis

sue

<3

<3

Gra

nd T

ota

l27

1710

2314

6689

106

154

160

182

172

154

102

5947

323

1417

ICD

10

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C02

Mal

igna

nt n

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lasm

o

f oth

er a

nd u

nsp

ecifi

ed

par

ts o

f to

ngue

<3

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C10

Mal

igna

nt n

eop

lasm

o

f oro

pha

rynx

<3

<3

C11

Mal

igna

nt n

eop

lasm

o

f nas

op

hary

nx<

3<

3<

3<

34

C16

Mal

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mac

h<

3<

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3<

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3<

3<

3<

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311

C17

Mal

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C18

Mal

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5<

34

34

24

C19

Mal

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junc

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3

C20

Mal

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4

C22

Mal

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trah

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35

C24

Mal

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3

C26

Mal

igna

nt n

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nd il

l-defi

ned

d

iges

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org

ans

<3

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C30

Mal

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asm

of

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r<

3<

3

C34

Mal

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nchu

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d lu

ng<

3<

33

4<

33

<3

317

C40

Mal

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rtic

ular

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ge

of l

imb

s<

3<

3<

3

APPENDICE 5

MA

LIG

NA

NT

CA

SES

DIS

TRIB

UTI

ON

BY

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E G

RO

UP

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MO

NG

QA

TAR

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68 69


ICD

10

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C41

Mal

igna

nt n

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o

f bo

ne a

nd a

rtic

ular

ca

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ge

of o

ther

and

un

spec

ified

site

s

<3

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3

C43

Mal

igna

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elan

om

a o

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n<

3<

3<

3<

34

C44

Oth

er a

nd

unsp

ecifi

ed m

alig

nant

ne

op

lasm

of s

kin

<3

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<3

<3

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7

C49

Mal

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nt n

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o

f oth

er c

onn

ectiv

e an

d

soft

tis

sue

<3

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3

C50

Mal

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ast

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57

86

96

3<

3<

3<

352

C53

Mal

igna

nt n

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o

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vix

uter

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3<

33

C54

Mal

igna

nt n

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o

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rpus

ute

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3<

3<

3<

37

<3

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<3

16

C55

Mal

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t un

spec

ified

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C56

Mal

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3<

3<

3<

36

C60

Mal

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3

C61

Mal

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33

44

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14

C62

Mal

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33

C64

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MA

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NT

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DIS

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10

Pri

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tes

Ag

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roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+U

NK

Gra

nd

Tota

l

C67

Mal

igna

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3<

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3<

3<

35

C71

Mal

igna

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lasm

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in3

<3

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<3

<3

3<

3<

312

C73

Mal

igna

nt n

eop

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o

f thy

roid

gla

nd<

33

<3

3<

33

<3

13

C80

Mal

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nt n

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w

itho

ut s

pec

ifica

tion

of

site

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<3

<3

4

C81

Ho

dg

kin

lym

pho

ma

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<3

<3

<3

<3

7

C82

Fo

llicu

lar

lym

pho

ma

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C83

No

n-fo

llicu

lar

lym

pho

ma

<3

<3

<3

<3

<3

<3

6

C85

Oth

er s

pec

ified

and

un

spec

ified

typ

es o

f no

n-H

od

gki

n ly

mp

hom

a<

3<

3<

33

C91

Lym

pho

id le

ukem

ia3

<3

<3

<3

<3

<3

9

C92

Mye

loid

leuk

emia

<3

<3

<3

D45

Po

lycy

them

ia v

era

<3

<3

<3

3

D47

Oth

er n

eop

lasm

s o

f unc

erta

in b

ehav

ior

of

lym

pho

id, h

emat

op

oie

tic

and

rela

ted

tis

sue

<3

<3

Gra

nd T

ota

l3

72

52

1112

1319

2033

3634

1919

1014

326

2

MA

LIG

NA

NT

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SES

DIS

TRIB

UTI

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BY

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RO

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QA

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IS

70 71


ICD

210

Pri

mar

y Si

tes

Ag

e G

roup

s

0-4

5-9

10-

14

15-

19

20-

24

25-

29

30-

34

35-

39

40-

44

45-

49

50-

54

55-

59

60-

64

65-

69

70-

74

75-

7980

+G

rand

Tota

l

C02

Mal

igna

nt n

eop

lasm

of

oth

er a

nd u

nsp

ecifi

ed p

arts

o

f to

ngue

<3

<3

3<

3<

3<

311

C04

Mal

igna

nt n

eop

lasm

of

floo

r o

f mo

uth

<3

<3

C05

Mal

igna

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APPENDICE 7

76 77


PATIENT INFORMATION

(1) Patient Name

First Father Grand father Family

(2) Qatar ID Number

(3) Visa Number

(4) Nationality (5) Telephone number (6) Gender

1 Male

2 Female

3 Other

(hermaphrodite)

4 Transsexual

9 Unknown

(7) Ethnic Group

1 Arab

2 Indian

3 European

4 African

5 Asian

9 Other

(8) Date of Birth

d d m m y y y y

(If DOB unknown, specify AGE) (If only year is known, use 01/07/yyyy)

Age ( years)

CASE INFORMATION

Identifying Information

(9) Level of Education

1 Illiterate

2 Read/ Write

3 Primary

4 Intermediate/ Secondary

5 Professional diploma

6 University

7 High education

9 Unknown

(10) Family History of Cancer

1 First degree relatives (parents, sibling and offspring)

2 Second degree relatives (grandparents, aunts, uncles)

4 Free - No History of cancer in the family

9 Unknown

(11) Alcohol history

1 Never used

2 Drinking alcohol

4 Previous use

9 Unknown

Text

(12) Smoking status / History

0 Never used

1 Cigarette smoker, Current

2 Cigar/ Pipe smoker, Current

3 Sheesha smoker, Current

4 Snuff/ Chew/ Smokeless, Current

5 Combination use, Current

6 Previous use

9 Unknown

(13) Occupation (14) Marital status at diagnosis

1 Single

2 Married

3 Divorced

4 Widowed

9 Unknown

(15) Patient address at diagnosis

City

Region

APPENDICE 8 DATA NOTIFICATION FORM

CASE INFORMATION

Diagnosis

(16) Date of Birth

d d m m y y y y

(17) Place of diagnosis (18) Date of Birth

d d m m y y y y

(19) Place of first presentation

1 Clinic

2 ER / Triage

3 Hospital

4 Other

9 Unknown

(20) Basis of diagnosis

0 DCO

1 Clinical

2 Radiology

3 Surgery/Autopsy

4 Lab test

5 Cytology/Hematology

6 Histology of metastasis

7 Histology of Primary

8 Histology , NOS

8 Unknown

(21) Co-morbidities ICD-10

CASE INFORMATION

Cancer Identification

(22) Class of case

Diagnosis at the reporting facility and all treatment or a decision not to treat was done elsewhere

Initial diagnosis at the reporting facility, and part or all of first course treatment or a decision not to treat was at the reporting facility

Initial diagnosis elsewhere and all or part of first course treatment or a decision not to treat was done at the reporting facility

Initial diagnosis elsewhere and all or part of first course treatment or a decision not to treat was done at the reporting facility

Case diagnosed before QNCR‘s Reference Date (January 2014), having initial diagnosis AND part or all of first course treatment by reporting facility

Initial diagnosis established by autopsy at the reporting facility, cancer not suspected prior to death

Diagnosis and all first course treatment given at the same staff physician‘s office

Pathology or other lab specimens only, excluding autopsy

Death certificate only, used by central registries only.

Unknown, no sufficient information in patient records. Used by central registries only

(23) Topography

ICDO Code

Text

(23) Topography

ICDO Code

Text

(23) Behavior

0 Benign

1 Uncertain

2 In Situ

3 Malignant/Invasive

6 Metastasis

78 79


(26) Grade

1 Well

2 Moderate

3 Poor

4 Undifferentiated

5 T-Cell

6 B-Cell

7 Null Cell

8 NK Cell

9 NOS

(27) Grade

None

Peritoneum

Lung

Pleura

Liver

Bone

CNS

Skin

L. Nodes

Other

(28) Laterality

1 Not paired,

1 Right

1 Left

1 One side, But Unknown

1 Bilateral Involvement, Side of origin Unknown

1 Paired site, Laterality Unknown

(29) Multiplicity counter

(30) Tumor markers

CASE INFORMATION

Staging

(31) Clinical TNM T N M Group T.Size

(32) Pathological TNM T N M Group T.Size

(33) SEER summary stage

1 In Situ

2 Localized

3 Regional by direct extension

4 Regional to lymph node

5 Regional (both 3 and 4)

6 Regional, NOS

7 Distant Metastasis/Systematic disease

9 Unknown

(34) Pediatric stage

(34) Other stage

CASE INFORMATION

Treatment

(36)

Surgery

(37) Date of main operation

d d m m y y y y

(38) Regional lymph nodes

Examined Positive

(39) Operation name (40) Intent of Rx

Curative

Palliative

Unknown

(41) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(42)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

(43)

Chemo

therapy

(44) Date of therapy

d d m m y y y y

(45) Drug name (46) Intent of Rx

Curative

Palliative

Unknown

(47) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(48)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

(49)

Hormone

Therapy


d d m m y y y y


Curative

Palliative

Unknown

(53) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(54)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

(55)

Radio-

therapy

(56) Date of start of therapy

d d m m y y y y

(57) Date of end of therapy

d d m m y y y y

(58) Intent of Rx

Curative

Palliative

Unknown

(59) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(60)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

(61)

Immuno-

therapy


d d m m y y y y


Curative

Palliative

Unknown

(65) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(66)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

80 81


(67)

BMT


d d m m y y y y

(69) BMT type

No BMT

Type not specified

Autologus

Allogenic

Stem Cell

Unknown

(70) Intent of Rx

Curative

Palliative

Unknown

(71) Location of Rx

In this hospital

Elsewhere in Qatar

Abroad

(72)Response of Rx

Not Documented

Complete Remission

Partial Response

Stable Disease

Disease Progression

Unknown

(73) Surgeon name (74) Oncologist name (75) Radiotherapy physician name

CASE INFORMATION

Follow Up

(76) Recurrence site

None

Local

Regional

Distant

(77) Distant site

None Bone

Peritoneum CNS

Lung Skin

Pleura L.Nodes

Liver Other


d d m m y y y y

(79) Cancer status

Evidence of tumor

No evidence of tumor

Unknown


d d m m y y y y

(81) Performance status post treatment

Normal activity

Symptomatic and ambulatory

Ambulatory > 50%

Ambulatory < 50%

Bedridden

Not applicable, dead

Unknown

(82) Medical record number

(83) Vital status

Alive

Dead

Unknown

(84) Date of death

d d m m y y y y

(85) Underlying cause of death (86) Place of death

Hospital

Home

Abroad

Unknown

(87) Notes

(85) Registrar’s name: (78) Date of therapy

d d m m y y y y

This report was made under the leadership and the review of Dr. Saleh Al Marri, Ministry of Public Health

The Qatar Cancer Incidence Annual Report for 2015 was mainly edited by Mr. Amid Abu Hmaidan, Manager of the Cancer Registry.

Special thanks to Fiona Bonas Director of the National Cancer Program.

The following healthcare providers and stakeholder largely participated through the reporting of cancer incidence data within timelines and according to the QNCR policy:

• National Center for Cancer Care and Research in HMC

• Al Ahli Hospital• Al Emadi Hospital• Doha Clinic Hospital• American Hospital• Al Borg Laboratories• Micro Health Laboratories • HMC-sidra pediatric service• AXA Health Insurance Company• MOPH Death Database• MOI Database

ACKNOWLEDGEMENT

HMC cancer registry, led by Dr. Mufid M. El Mistiri, and his team were supportive in providing the necessary data.

Big thank you for:

• Dr. Delaram Ardalan, from Al Borg Laboratories• Dr. Rafif Al Saady, form Al Ahli Hospital• Ms. Parvaneh Amani, from Al Emadi Hospital.

For their dedication, support and quality data reported.

We would like to extend our thanks to Dr. Roberto Bertollini, Senior Advisor for the Minister of Public Health, for his in-depth advice and recommendations for the scientific content of the report.

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REFERENCES

1. Bonio, M., & Heanue, M. (n.d.). IARC, CI: Age Standardization and Denominators.

2. Ferlay J, S. I. (2012). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Retrieved from http://globocan.iarc.fr

3. IARC, I. A. (2012). Globocan 2012. Lyon, France.

4. Parkin, P. B. (n.d.). Chapter 11. Statistical methods for registries. IARC.

5. WHO. (2001). Discussion Paper 31: Age Standardization of Rates: A New WHO Standard (PDF)External Web Site Policy,. Retrieved from http://www.who.int/healthinfo/paper31.pdf

6. WHO. (2010). International Statistical Classification of Diseases and Related Health Problems, Volume 2

Documents

2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 QATAR NATIONAL CANCER REGISTRY QNCR - ANNUAL REPORT - 2015 FOREWORD I welcome the publication of the 2015 Qatar National